中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2010年
16期
1120-1122
,共3页
俞洪元%陈柏康%张显军%李飞平%王天济%丁崇标%吴松江%卢子文%柯莽%张文刚
俞洪元%陳柏康%張顯軍%李飛平%王天濟%丁崇標%吳鬆江%盧子文%柯莽%張文剛
유홍원%진백강%장현군%리비평%왕천제%정숭표%오송강%로자문%가망%장문강
肾肿瘤%癌%肾切除%根治性肾切除
腎腫瘤%癌%腎切除%根治性腎切除
신종류%암%신절제%근치성신절제
Kidney neoplasms%Carcinoma%Nephrectomy%Radical nephrectomy
目的 比较肾癌单纯性肾切除与根治性肾切除的疗效及安全性.方法 对134例无淋巴和远处转移临床资料基本相同的肾癌患者,选取69例肾癌患者行肾癌单纯性肾切除,另65例行根治性肾切除,总结两组患者临床资料,并对手术时间、手术出血量、术后禁食时间、术后住院时间、肿瘤复发情况、肿瘤转移、无瘤生存时间、生存率、并发症发生等指标进行比较.结果 单纯组手术时间60～135 min,出血量70～100 ml,胸腹膜损伤4例;术后禁食时间6～24 h,术后住院时间5～8 d;所有患者均获得肿瘤分期;随访5～15年,死亡4例(非癌死亡2例),肾上腺转移1例,复发2例.根治组手术时间105～185 min,术中出血150～2000 ml,胸腹膜损伤3例;术后禁食时间12～90 h,术后住院时间8～12 d;所有患者获得肿瘤分期;随访5～15年,死亡4例(非癌死亡1例),复发1例.两组手术并发症、肿瘤复发转移、无瘤生存时间差异无统计学意义(P＞0.05),单纯组手术时间、手术出血量、术后禁食时间、术后住院时问明显少于根治组(P＜0.05).结论 对无淋巴和远处转移的肾癌,单纯性肾切除是一种高效、安全的治疗方法,在手术时间和术后住院时间、减少创伤及减少出血方面比根治术更优越.
目的 比較腎癌單純性腎切除與根治性腎切除的療效及安全性.方法 對134例無淋巴和遠處轉移臨床資料基本相同的腎癌患者,選取69例腎癌患者行腎癌單純性腎切除,另65例行根治性腎切除,總結兩組患者臨床資料,併對手術時間、手術齣血量、術後禁食時間、術後住院時間、腫瘤複髮情況、腫瘤轉移、無瘤生存時間、生存率、併髮癥髮生等指標進行比較.結果 單純組手術時間60～135 min,齣血量70～100 ml,胸腹膜損傷4例;術後禁食時間6～24 h,術後住院時間5～8 d;所有患者均穫得腫瘤分期;隨訪5～15年,死亡4例(非癌死亡2例),腎上腺轉移1例,複髮2例.根治組手術時間105～185 min,術中齣血150～2000 ml,胸腹膜損傷3例;術後禁食時間12～90 h,術後住院時間8～12 d;所有患者穫得腫瘤分期;隨訪5～15年,死亡4例(非癌死亡1例),複髮1例.兩組手術併髮癥、腫瘤複髮轉移、無瘤生存時間差異無統計學意義(P＞0.05),單純組手術時間、手術齣血量、術後禁食時間、術後住院時問明顯少于根治組(P＜0.05).結論 對無淋巴和遠處轉移的腎癌,單純性腎切除是一種高效、安全的治療方法,在手術時間和術後住院時間、減少創傷及減少齣血方麵比根治術更優越.
목적 비교신암단순성신절제여근치성신절제적료효급안전성.방법 대134례무림파화원처전이림상자료기본상동적신암환자,선취69례신암환자행신암단순성신절제,령65례행근치성신절제,총결량조환자림상자료,병대수술시간、수술출혈량、술후금식시간、술후주원시간、종류복발정황、종류전이、무류생존시간、생존솔、병발증발생등지표진행비교.결과 단순조수술시간60～135 min,출혈량70～100 ml,흉복막손상4례;술후금식시간6～24 h,술후주원시간5～8 d;소유환자균획득종류분기;수방5～15년,사망4례(비암사망2례),신상선전이1례,복발2례.근치조수술시간105～185 min,술중출혈150～2000 ml,흉복막손상3례;술후금식시간12～90 h,술후주원시간8～12 d;소유환자획득종류분기;수방5～15년,사망4례(비암사망1례),복발1례.량조수술병발증、종류복발전이、무류생존시간차이무통계학의의(P＞0.05),단순조수술시간、수술출혈량、술후금식시간、술후주원시문명현소우근치조(P＜0.05).결론 대무림파화원처전이적신암,단순성신절제시일충고효、안전적치료방법,재수술시간화술후주원시간、감소창상급감소출혈방면비근치술경우월.
Objective To compare the clinical efficacy and safety of nephrectomy versus radical nephrectomy for renal cell carcinoma(RCC).Methods A total of 134 patients with renal carcinoma without metastasis in lymphatic system and distant sites were recruited.In random.69 cases of renal cell carcinoma were elected for nephrectomy and the others radical nephrectomy.The operating time,blood loss,fasting time,postoperative hospital stay,information of tumor recurrence and metastasis,survival time without tumor,survival rate and perioperative complication were compared between two groups.Results In cases of nephrectomy,the operating time ranged from 60-135 minutes and blood loss 70-100 mL In 4 cases,membrana pleuroperitonealis was damaged. The fasting time ranged from 6-24 hours and postoperative hospital stay 5-8 days;the staging of all 69 cases was detected;follow-up studies ranged from 5-15 years,finding 1 case tumor metastasis in adrenal body and 1 case recurrent tumor in csaes of radical nephrectomy,operating time ranged from 105-185 minutes and blood loss 150-2000 ml.Membrana pleuroperitonealis was breached in 3 cases.The fasting time ranged from 12-90 hours and postoperative hospital stay 8-12 days.The staging of all 65 cases was detected.Follow-up studies of 5-15 years revealed 1 case of tumor metastasis in brain and 1 case of recurrent tumor.There was no significant difference in perioperative complication.tumor recurrence,tumor metastasis and survival time without tumor between those two groups(P＞0.05).The blood loss,operating time,fasting and postoperative hospital stay were less than that in radical nephrectomy group(P＜0.05).Conclusion In patients without metastasis in lymphatic system and distant sites,nephrectomy is both effective and safe.It has the advantages of a short operating time,a short postoperative hospital stay and less damage and blood loss than radical nephrectomy.
